RACE/ETHNICITY DISPARITY FOR PEOPLE WITH LTSS NEEDS IN CALIFORNIA: DISABILITY, FINANCE, AND HEALTH AND WELL-BEING

Abstract Older adults and people with disabilities have high needs for Long-Term Services and Supports (LTSS). Disability status, financial difficulties, and health and well-being are likely not uniformly experienced by all people with LTSS needs. Subgroups of older adults and people with disabilities, such as racial/ethnic minorities, may be at significant risk of experiencing financial difficulties and stress about making ends meet. This study used the first cycle of data (2019-2020) from the California Long-Term Services and Supports (CA-LTSS) survey, merged with select data from the California Health Interview Survey (CHIS) (N = 2,030). Multivariate Regressions and Conditional Process Analysis (CPA) were applied to test the hypothesized relationships. Findings show that black/African American and Asian participants with LTSS needs were more likely to have cognitive impairments. Black/African American participants with LTSS needs were more likely to report difficulties in activities of daily living. Racial/ethnic minorities with LTSS needs experienced diverse and more financial difficulties on average than their white counterparts. Asian participants with LTSS needs reported worse psychological distress than other racial/ethnic groups. American Indians and Alaska Natives with cognitive impairments were more likely to have more financial difficulties, and those with difficulty in instrumental activities of daily living were more likely to report worse self-rated health. This study moves beyond the typical white/black disparities analyses and focuses on diverse racial/ethnic groups. We need to address the financial needs of various racial/ethnic groups of people with LTSS needs and target policies and service programs to meet their mental health needs.


NIMHD INVESTMENTS IN RESEARCH ON OLDER ADULTS EXPERIENCING HEALTH DISPARITIES: 2018-2022
Aaron Ogletree 1 , Michelle Doose 2 , and Yewande Oladeinde 2 , 1. National Institutes of Health,Bethesda,MAryland,United States,2. National Institutes of Health,Bethesda,Maryland,United States The National Institute on Minority Health and Health Disparities (NIMHD) is the nation's leading institute on the health of populations experiencing health disparities.These populations include individuals with low socioeconomic status (SES), those living in rural areas, sexual and gender minorities (SGM), and racial and ethnic minorities.Despite the need to advance research on these populations, particularly in old age when health disparities may be most salient, there has been no analysis of NIMHD funding on older adults to date.This portfolio analysis synthesized and described NIMHD's investments in research on older adults using data from fiscal years 2018 through 2022.The Research, Condition, and Disease Categorization system was used to identify funded projects in the area of Aging; manual review confirmed project eligibility.In-depth project characteristics were extracted and topic areas evaluated.Findings demonstrate that NIMHD funded a total of 98 unique research projects focused on older adults.Of these, 47% focused on the etiology of health disparities, 38% on interventions, and 15% on methods and measurement.The most specified population was racial and ethnic minorities (91%), followed by individuals with low SES (21%), rural older adults (11%), and SGM older adults (8%).Projects focused on diagnostic or clinical care (16%), care coordination (6%), caregivers (6%), and shared decision-making (4%) were limited.Findings highlight opportunities for future research to advance health care and reduce health disparities for the growing proportion of older adults from populations experiencing health disparities.Older adults and people with disabilities have high needs for Long-Term Services and Supports (LTSS).Disability status, financial difficulties, and health and well-being are likely not uniformly experienced by all people with LTSS needs.Subgroups of older adults and people with disabilities, such as racial/ethnic minorities, may be at significant risk of experiencing financial difficulties and stress about making ends meet.This study used the first cycle of data (2019-2020) from the California Long-Term Services and Supports (CA-LTSS) survey, merged with select data from the California Health Interview Survey (CHIS) (N = 2,030).Multivariate Regressions and Conditional Process Analysis (CPA) were applied to test the hypothesized relationships.Findings show that black/African American and Asian participants with LTSS needs were more likely to have cognitive impairments.Black/African American participants with LTSS needs were more likely to report difficulties in activities of daily living.Racial/ethnic minorities with LTSS needs experienced diverse and more financial difficulties on average than their white counterparts.Asian participants with LTSS needs reported worse psychological distress than other racial/ethnic groups.American Indians and Alaska Natives with cognitive impairments were more likely to have more financial difficulties, and those with difficulty in instrumental activities of daily living were more likely to report worse self-rated health.This study moves beyond the typical white/ black disparities analyses and focuses on diverse racial/ethnic groups.We need to address the financial needs of various racial/ethnic groups of people with LTSS needs and target policies and service programs to meet their mental health needs.Visceral adipose tissue (VAT) has a more significant role in the pathophysiology of cardiometabolic diseases than subcutaneous adipose tissue (SAT).Our previous findings suggest VAT represents an important pathway through which racial disparities in the social environment are biologically embodied.To understand the role of structural racism in this pathway, this paper investigated racial disparities in neighborhood socioeconomic status (NSES) and VAT.We hypothesized that NSES is inversely associated with VAT and VAT/ SAT ratio over 6 years and associations differ by race and ethnicity.Abdominal VAT and SAT area (cm2) were measured at years 0, 3, and 6 using dual-energy X-ray absorptiometry in a subsample (n=11,020) of the Women's Health Initiative (age 50-79).The NSES Z-scores were obtained from the US Census and American Community Survey based on participant's census tract residence.We evaluate racial and ethnic disparities in the exposure and outcome using ANOVA, and associations between NSES with VAT using mixed effects models.We found that NSES and VAT area differed by race and ethnicity.American Indian and Alaska Native (AIAN), Black, and Latina groups were significantly (P< 0.01) more likely to live in neighborhoods with NSES Z-scores below the population mean (Z-score=0) compared with White and Asian races.AIAN, Latina, and Black women had the highest VAT (220 cm2, 185 cm2, 177 cm2, respectively).Findings support the hypothesis that associations between NSES and VAT differ by race and ethnicity.Results from mixed effects models are expected to provide longitudinal evidence that structural determinants are associated with VAT.

RACIAL AND NATIVITY DIFFERENCES IN ADVERSITY PROFILES AMONG MIDDLE-AGED AND OLDER ADULTS
Man Guo, Yi Wang, and Kara Carter, University of Iowa, Iowa City, Iowa, United States Cumulative adversity theory explains how distribution of resources and stress accumulate over time, resulting in divergent later life outcomes.Focusing on the nexus of race and nativity, this study examined profiles of adversity (i.e., the overall typological patterns of adversity) and their mental health implications in four groups of middle-aged and older adults: native-born whites, native-born ethnic minorities, foreign-born whites, and foreign-born ethnic minorities.Data were from the 2018 psychosocial assessment of the HRS (N = 5,534).Latent class analysis (LCA) with multigroup analyses were employed to identify typological patterns of ten adversity indicators and to compare the latent structures and class prevalence across the race/nativity groups.Regressions were used to examine the associations between adversity profiles and three outcomes: depression, pessimism, and life satisfaction.adversity profiles emerged: low adversity (60.05%), low human capital (15.69%), socially marginalized (13.67%), and neighborhood adversity (10.59%).These adversity profiles were structurally the same for the four race/nativity groups, but the class prevalence varied across the groups.Overall, having low adversity profile was associated with the best mental health outcomes.However, the mental health implications of each adversity profile varied by outcomes and by race and/or nativity.Findings highlight the importance of examining heterogeneity in adversity and its mental health implications among disadvantaged populations and the need of developing tailored programs to address unique needs of different minority populations.

REPRODUCTIVE AGING Chair: Yousin Suh
Reproductive aging is a major health, personal and societal issue, but ovarian aging has received limited scientific attention.Ovarian aging has been known to influence diverse health outcomes in women including lifespan, cardiovascular disease, metabolic syndromes, neurodegenerative disorders and various types of cancer.Yet, the mechanisms behind this broad implication remain elusive.This session will explore recent insights into the molecular, cellular and genetic basis of ovarian aging and new intervention targets to maintain reproductive health and later health outcomes in our aging female population.

Target audience:
This inter-disciplinary session is designed to educate basic scientists, physician-scientists, clinicians, and a general interest audience of providers or industry representatives interested in understanding the mechanisms of ovarian aging and its sequalae.

OVARIAN AGING: A TARGET FOR GEROPROTECTION IN WOMEN Yousin Suh, Columbia University, New York City, New York, United States
The ovary is the first organ to undergo early-onset aging in the human body, affecting both fertility and overall